Epidemiology of community-acquired meticillin-resistant Staphylococcus aureus obtained from the UK West Midlands region

• Published in: The Journal of hospital infection Vol. 70; no. 4; pp. 314 - 320
• Main Authors: Rollason, J, Bastin, L, Hilton, A.C, Pillay, D.G, Worthington, T, McKeon, C, De, P, Burrows, K, Lambert, P.A
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-12-2008; Elsevier
• Subjects: Anti-Bacterial Agents - pharmacology; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Bacterial Proteins - genetics; Biological and medical sciences; Community; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Electrophoresis, Gel, Pulsed-Field; EMRSA-15; EMRSA-16; Genotype; Human bacterial diseases; Humans; Infectious Disease; Infectious diseases; Medical sciences; Methicillin - pharmacology; Methicillin Resistance - genetics; Methicillin-Resistant Staphylococcus aureus - classification; Methicillin-Resistant Staphylococcus aureus - drug effects; Methicillin-Resistant Staphylococcus aureus - genetics; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Meticillin-resistant Staphylococcus aureus; Microbial Sensitivity Tests; Penicillin-Binding Proteins; Pharmacology. Drug treatments; Phenotype; Polymerase Chain Reaction; Pulsed-field gel electrophoresis; SCCmec; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus; United Kingdom - epidemiology; United Kingdom; Europe; United Kingdom > UK; Pulsed-field gel electrophoresis; EMRSA-16; SCC mec; Meticillin-resistant Staphylococcus aureus; Community; EMRSA-15; SCCmec; β-Lactams; Epidemiology; Meticillin; Penicillin derivatives; Infection; Antibiotic; Pulsed field electrophoresis; Community acquired infection; Bacteriosis; Bacteria; Micrococcales; Micrococcaceae; Meticillin- resistant Staphylococcus aureus; Antibacterial agent; Staphylococcal infection; Public health; Staphylococcus aureus
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2008.08.004

Summary Between January 2005 and December 2005, 199 meticillin-resistant Staphylococcus aureus (MRSA) isolates were obtained from non-hospitalised patients presenting skin and soft tissue infections to local general practitioners. The study area incorporated 57 surgeries from three Primary Care Trusts in the Lichfield, Tamworth, Burntwood, North and East Birmingham regions of Central England, UK. Following antibiotic susceptibility testing, pulsed-field gel electrophoresis, Panton–Valentine leukocidin gene detection and SCC mec element assignment, 95% of the isolates were shown to be related to hospital epidemic strains EMRSA-15 and EMRSA-16. In total 87% of the isolate population harboured SCC mec IV, 9% had SCC mec II and 4% were identified as carrying novel SCC mec IIIa - mec I . When mapped to patient home postcode, a diverse distribution of isolates harbouring SCC mec II and SCC mec IV was observed; however, the majority of isolates harbouring SCC mec IIIa - mec I were from patients residing in the north-west of the study region, highlighting a possible localised clonal group. Transmission of MRSA from the hospital setting into the surrounding community population, as demonstrated by this study, warrants the need for targeted patient screening and decolonisation in both the clinical and community environments.